Evidence mapPaperPMID 34644366Full record

ArticlePloS one2021

Four-year safety and effectiveness data from patients with multiple sclerosis treated with fingolimod: The Spanish GILENYA registry.

J E Meca-Lallana, C Oreja-Guevara, D Muñoz, J Olascoaga, A Pato, L Ramió-Torrentà, V Meca-Lallana, M A Hernández, M E Marzo, J C Álvarez-Cermeño and 4 more

Abstract read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

J E Meca-LallanaNeurology Department, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.ORCID 0000-0001-5050-9890
C Oreja-GuevaraNeurology Department, Hospital Clínico San Carlos, Madrid, Spain.ORCID 0000-0002-9221-5716
D MuñozNeurology Department, Hospital Xeral de Vigo, Vigo, Spain.
J OlascoagaNeurology Department, Hospital Universitario Donostia, San Sebastián, Spain.
A PatoNeurology Department, Hospital Povisa, Vigo, Spain.
L Ramió-TorrentàNeurology Department, Hospital Universitari de Girona Dr. Josep Trueta, IDIBGI; Medical Sciences Department, University of Girona, Girona, Spain.
V Meca-LallanaNeurology Department, Hospital Universitario de La Princesa, Madrid, Spain.
M A HernándezNeurology Department, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
M E MarzoHospital San Pedro, Logroño, Spain.
J C Álvarez-CermeñoNeurology Department, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain.
A Rodríguez-AntigüedadNeurology Department, Hospital Universitario Cruces, Barakaldo, Spain.
X MontalbánNeurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
O FernándezDepartment of Pharmacology, Faculty of Medicine, Universidad de Málaga; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.ORCID 0000-0003-3696-789X
Spanish GILENYA Registry Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo describe the profile of patients with multiple sclerosis (MS) treated with fingolimod in Spain and to assess the effectiveness and safety of fingolimod after 4 years of inclusion in the Spanish Gilenya Registry.

methodsAn observational, retrospective/prospective, multicenter case registry, including all patients with relapsing-remitting MS (RRMS) starting treatment with fingolimod in 43 centers in Spain. Analyses were performed in the overall population and in subgroups according to prior disease-modifying therapy (DMT): glatiramer acetate/interferon beta-1 (BRACE), natalizumab, other treatment, or naïve.

resultsSix hundred and sixty-six evaluable patients were included (91.1% previously treated with at least one DMT). The mean annualized relapse rate (ARR) prior to fingolimod was 1.12, and the mean EDSS at fingolimod initiation was 3.03. Fingolimod reduced the ARR by 71.4%, 75%, 75.5%, and 80.3%, after 1, 2, 3 and 4 years, respectively (p<0.001). This significant reduction in the ARR continued to be observed in all subgroups. After 4 years, the EDSS showed a minimal deterioration, with the EDSS scores from year 1 to year 4 remaining mostly stable. The percentage of patients without T1 Gd+ lesions progressively increased from 45.6% during the year prior to fingolimod initiation to 88.2% at year 4. The proportion of patients free from new/enlarged T2 lesions after 4 years of fingolimod treatment was 80.3%. This trend in both radiological measures was also observed in the subgroups. Adverse events (AEs) were experienced by up to 41.6% of patients (most commonly: lymphopenia [12.5%] and urinary tract infection [3.7%]). Most AEs were mild in severity, 3.6% of patients had serious AEs.

conclusionsThe patient profile was similar to other observational studies. The results obtained from the long-term use of fingolimod showed that it was effective, regardless of prior DMT, and it had adequate safety results, with a positive benefit-risk balance.

Indexed as

AdultFemaleFingolimod HydrochlorideHumansImmunosuppressive AgentsLymphopeniaMaleMiddle AgedMultiple SclerosisRecurrenceRegistriesRetrospective StudiesSpainTreatment OutcomeFingolimod HydrochlorideImmunosuppressive Agents

Identifiers

PMID34644366
PMCPMC8513911

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.